Individual provider · Type 1 NPI
Mary Eileen Kumah Russell, ACNP
Gerontology Nurse Practitioner · Philadelphia, PA
NPI number
1417518747
Active
Practice location
1650 Market St Ste 3600
Philadelphia, PA 19103-7334
Fax (629) 240-6003
Mailing address
5410 Maryland Way Ste 400, Ste. A
Brentwood, TN 37027-8087
Other practice locations
- 625 N 6th St, Phoenix, AZ 85004-2155 · (602) 406-8222
- 7330 N 99th Ave Ste 300350, Glendale, AZ 85307-3015 · (602) 406-0220
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 228209 (AZ) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1417518747
Mary Eileen Kumah Russell, ACNP's National Provider Identifier is 1417518747, issued on Jun 26, 2019. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Philadelphia, PA. The record was last updated on Oct 19, 2026.